دورية أكاديمية
أعرض في EDS

Intraoperative liver deformation and organ motion caused by ventilation, laparotomy, and pneumoperitoneum in a porcine model for image-guided liver surgery.

التفاصيل البيبلوغرافية
العنوان: Intraoperative liver deformation and organ motion caused by ventilation, laparotomy, and pneumoperitoneum in a porcine model for image-guided liver surgery.
المؤلفون: Wise PA; Department of General, Visceral and Transplantation Surgery, Heidelberg University, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany., Preukschas AA; Department of General, Visceral and Transplantation Surgery, Heidelberg University, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany.; Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany., Özmen E; Department of General, Visceral and Transplantation Surgery, Heidelberg University, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany., Bellemann N; Department of Diagnostic and Interventional Radiology, Heidelberg University, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany., Norajitra T; Division of Medical and Biological Informatics, German Cancer Research Center, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany., Sommer CM; Department of Diagnostic and Interventional Radiology, Heidelberg University, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany., Stock C; Institute for Medical Biometry and Informatics, Heidelberg University, Im Neuenheimer Feld 305, 69120, Heidelberg, Germany., Mehrabi A; Department of General, Visceral and Transplantation Surgery, Heidelberg University, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany., Müller-Stich BP; Division of Abdominal Surgery, Clarunis-Academic Centre of Gastrointestinal Diseases, St. Clara and University Hospital of Basel, Petersgraben 4, 4051, Basel, Switzerland., Kenngott HG; Department of General, Visceral and Transplantation Surgery, Heidelberg University, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany., Nickel F; Department of General, Visceral and Transplantation Surgery, Heidelberg University, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany. f.nickel@uke.de.; Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany. f.nickel@uke.de.
المصدر: Surgical endoscopy [Surg Endosc] 2024 Mar; Vol. 38 (3), pp. 1379-1389. Date of Electronic Publication: 2023 Dec 26.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Springer Country of Publication: Germany NLM ID: 8806653 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-2218 (Electronic) Linking ISSN: 09302794 NLM ISO Abbreviation: Surg Endosc Subsets: MEDLINE
أسماء مطبوعة: Publication: 1992- : New York : Springer
Original Publication: [Berlin] : Springer International, c1987-
مواضيع طبية MeSH: Organ Motion* , Pneumoperitoneum*/diagnostic imaging , Pneumoperitoneum*/etiology, Swine ; Animals ; Laparotomy ; Liver/diagnostic imaging ; Liver/surgery ; Respiration
مستخلص: Background: Image-guidance promises to make complex situations in liver interventions safer. Clinical success is limited by intraoperative organ motion due to ventilation and surgical manipulation. The aim was to assess influence of different ventilatory and operative states on liver motion in an experimental model.
Methods: Liver motion due to ventilation (expiration, middle, and full inspiration) and operative state (native, laparotomy, and pneumoperitoneum) was assessed in a live porcine model (n = 10). Computed tomography (CT)-scans were taken for each pig for each possible combination of factors. Liver motion was measured by the vectors between predefined landmarks along the hepatic vein tree between CT scans after image segmentation.
Results: Liver position changed significantly with ventilation. Peripheral regions of the liver showed significantly higher motion (maximal Euclidean motion 17.9 ± 2.7 mm) than central regions (maximal Euclidean motion 12.6 ± 2.1 mm, p < 0.001) across all operative states. The total average motion measured 11.6 ± 0.7 mm (p < 0.001). Between the operative states, the position of the liver changed the most from native state to pneumoperitoneum (14.6 ± 0.9 mm, p < 0.001). From native state to laparotomy comparatively, the displacement averaged 9.8 ± 1.2 mm (p < 0.001). With pneumoperitoneum, the breath-dependent liver motion was significantly reduced when compared to other modalities. Liver motion due to ventilation was 7.7 ± 0.6 mm during pneumoperitoneum, 13.9 ± 1.1 mm with laparotomy, and 13.5 ± 1.4 mm in the native state (p < 0.001 in all cases).
Conclusions: Ventilation and application of pneumoperitoneum caused significant changes in liver position. Liver motion was reduced but clearly measurable during pneumoperitoneum. Intraoperative guidance/navigation systems should therefore account for ventilation and intraoperative changes of liver position and peripheral deformation.
(© 2023. The Author(s).)
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فهرسة مساهمة: Keywords: Image guidance; Laparoscopic surgery; Liver motion; Mri; Soft tissue surgery; Ventilation
تواريخ الأحداث: Date Created: 20231226 Date Completed: 20240223 Latest Revision: 20240224
رمز التحديث: 20240224
مُعرف محوري في PubMed: PMC10881715
DOI: 10.1007/s00464-023-10612-x
PMID: 38148403
قاعدة البيانات: MEDLINE
الوصف
تدمد:1432-2218
DOI:10.1007/s00464-023-10612-x